999 resultados para Assistência médica - Brasil - Custos
Resumo:
Lung cancer is one of the most common types of cancer and has the highest mortality rate. Patient survival is highly correlated with early detection. Computed Tomography technology services the early detection of lung cancer tremendously by offering aminimally invasive medical diagnostic tool. However, the large amount of data per examination makes the interpretation difficult. This leads to omission of nodules by human radiologist. This thesis presents a development of a computer-aided diagnosis system (CADe) tool for the detection of lung nodules in Computed Tomography study. The system, called LCD-OpenPACS (Lung Cancer Detection - OpenPACS) should be integrated into the OpenPACS system and have all the requirements for use in the workflow of health facilities belonging to the SUS (Brazilian health system). The LCD-OpenPACS made use of image processing techniques (Region Growing and Watershed), feature extraction (Histogram of Gradient Oriented), dimensionality reduction (Principal Component Analysis) and classifier (Support Vector Machine). System was tested on 220 cases, totaling 296 pulmonary nodules, with sensitivity of 94.4% and 7.04 false positives per case. The total time for processing was approximately 10 minutes per case. The system has detected pulmonary nodules (solitary, juxtavascular, ground-glass opacity and juxtapleural) between 3 mm and 30 mm.
Resumo:
This study aims to understand the significance of palliative care for the elder health care professionals working in primary health care. Descriptive study of qualitative approach. Conducted in three health units of the Family and a core of support for Health, the Felipe Camarão neighborhood, District of Natal Health West, RN. Of the 25 participants, 19 are professionals of the Family Health Strategy and six of the Center for Support to Health, the majority being women, with minimal professional work experience, a year in primary health care. The study was approved by the Ethics Committee of the Federal University of Rio Grande do Norte, under CAAE no. 43895815.4.0000.5537. There were individual interviews between July and September 2015, with the use of questionnaire containing open and closed questions on the topic of study. Our results were recorded in MP4 and transcribed into written language, and analyzed using the open coding process medium in which the categories were interpreted and identified, followed by axial coding, where categories were developed and systematically related. Three categories emerged: enhancement of elder health professionals in palliative care, behavioral health professionals across care in palliative care in primary care and disjointed Meaning between palliative care and health professionals. The categories were interpreted and analyzed by the theoretical framework of social phenomenology of Alfred Schütz. Regarding the valuation of subjective perception of professionals, it is clear the issue of the complexity of multiple relationships through various aspects of his central task: focus a philosophy of the world's reality, namely a phenomenology of natural attitude; Before the professional behavior were identified: the discovery and depth of assumptions through the structure, and meaning in a common sense, and at the meaning of the disconnection between the health professionals-including that reality imminent can be represented by individuality special interest of the experience. It follows that health professionals understand there is a difficulty facing the assistance in palliative care to the elderly in primary care, and this difficulty, characterized by the complexity of social interactions across the joint teamwork. Although, I believe that the articulation between the teams, work and family, is essential for the subsequent improvement of care in palliative care favoring the health context surrounding the Elder.
Resumo:
This study aims to understand the significance of palliative care for the elder health care professionals working in primary health care. Descriptive study of qualitative approach. Conducted in three health units of the Family and a core of support for Health, the Felipe Camarão neighborhood, District of Natal Health West, RN. Of the 25 participants, 19 are professionals of the Family Health Strategy and six of the Center for Support to Health, the majority being women, with minimal professional work experience, a year in primary health care. The study was approved by the Ethics Committee of the Federal University of Rio Grande do Norte, under CAAE no. 43895815.4.0000.5537. There were individual interviews between July and September 2015, with the use of questionnaire containing open and closed questions on the topic of study. Our results were recorded in MP4 and transcribed into written language, and analyzed using the open coding process medium in which the categories were interpreted and identified, followed by axial coding, where categories were developed and systematically related. Three categories emerged: enhancement of elder health professionals in palliative care, behavioral health professionals across care in palliative care in primary care and disjointed Meaning between palliative care and health professionals. The categories were interpreted and analyzed by the theoretical framework of social phenomenology of Alfred Schütz. Regarding the valuation of subjective perception of professionals, it is clear the issue of the complexity of multiple relationships through various aspects of his central task: focus a philosophy of the world's reality, namely a phenomenology of natural attitude; Before the professional behavior were identified: the discovery and depth of assumptions through the structure, and meaning in a common sense, and at the meaning of the disconnection between the health professionals-including that reality imminent can be represented by individuality special interest of the experience. It follows that health professionals understand there is a difficulty facing the assistance in palliative care to the elderly in primary care, and this difficulty, characterized by the complexity of social interactions across the joint teamwork. Although, I believe that the articulation between the teams, work and family, is essential for the subsequent improvement of care in palliative care favoring the health context surrounding the Elder.
Resumo:
Tratar-se-á de um estudo metodológico, com abordagem quantitativa; baseado no referencial metodológico da técnica Delphi, com objetivo de construir e validar um protocolo clínico para assistência do enfermeiro ao paciente séptico na Unidade de Terapia Intensiva. A proposta metodológica seguiu duas etapas: elaboração do instrumento por meio da revisão integrativa da literatura e validação de conteúdo do protocolo. O estudo foi aprovado pelo Comitê de Ética em Pesquisa, mediante o Parecer CAAE 41873314.5.0000.5537. O universo amostral foi composto por profissionais enfermeiros, considerados peritos, doutores ou mestres na área da saúde, com experiência em alta complexidade e/ ou estudos de validação de instrumento/protocolo, selecionados por meio da Plataforma Lattes. Referente à primeira etapa elaborou-se um instrumento composto pela caracterização profissional dos peritos; e baseado em evidência científica e nas diretrizes do Surviving Sepsis Campaign, contemplando três tópicos assistenciais ao paciente com sepse, a saber: Triagem para Sepse- Reconhecimento das Manifestações Clínicas; Pacote de Ressuscitação Inicial (Controle das Primeiras 6 Horas); Tratamento de Suporte. A segunda etapa caracterizou-se na validação de conteúdo do instrumento para elaboração final do protocolo, utilizando à técnica Delphi, em duas fases. No que concernem as variáveis referentes ao estudo, na 1ª fase de Delphi, 34 peritos avaliaram o instrumento composto por 18 itens, no período de maio a julho de 2015, e os dados foram analisados pela estatística descritiva (frequência, média, mediana e desvio padrão) e pelo Índice de Validade de Conteúdo (IVC), demonstrando um IVC extremamente satisfatório para 15 itens, com total de 0,79, obtendo assim, a reformulação e refinamento do conteúdo do instrumento. Na segunda fase de Delphi, entre julho e agosto de 2015, participaram 26 peritos, e utilizou-se o percentual de concordância acima de 75% para as variáveis consideradas pertinentes ao protocolo de cuidados ao paciente séptico em UTI, obtendo nesta fase, o percentual de concordância de 95%. O protocolo foi concluído com 15 itens, sendo respaldado e modificado, baseado em evidência científica, nas diretrizes internacionais e nas sugestões dos peritos. A utilização do protocolo proposto poderá contribuir para a prática clínica do enfermeiro ao paciente séptico na Unidade de Terapia Intensiva.
Resumo:
Tratar-se-á de um estudo metodológico, com abordagem quantitativa; baseado no referencial metodológico da técnica Delphi, com objetivo de construir e validar um protocolo clínico para assistência do enfermeiro ao paciente séptico na Unidade de Terapia Intensiva. A proposta metodológica seguiu duas etapas: elaboração do instrumento por meio da revisão integrativa da literatura e validação de conteúdo do protocolo. O estudo foi aprovado pelo Comitê de Ética em Pesquisa, mediante o Parecer CAAE 41873314.5.0000.5537. O universo amostral foi composto por profissionais enfermeiros, considerados peritos, doutores ou mestres na área da saúde, com experiência em alta complexidade e/ ou estudos de validação de instrumento/protocolo, selecionados por meio da Plataforma Lattes. Referente à primeira etapa elaborou-se um instrumento composto pela caracterização profissional dos peritos; e baseado em evidência científica e nas diretrizes do Surviving Sepsis Campaign, contemplando três tópicos assistenciais ao paciente com sepse, a saber: Triagem para Sepse- Reconhecimento das Manifestações Clínicas; Pacote de Ressuscitação Inicial (Controle das Primeiras 6 Horas); Tratamento de Suporte. A segunda etapa caracterizou-se na validação de conteúdo do instrumento para elaboração final do protocolo, utilizando à técnica Delphi, em duas fases. No que concernem as variáveis referentes ao estudo, na 1ª fase de Delphi, 34 peritos avaliaram o instrumento composto por 18 itens, no período de maio a julho de 2015, e os dados foram analisados pela estatística descritiva (frequência, média, mediana e desvio padrão) e pelo Índice de Validade de Conteúdo (IVC), demonstrando um IVC extremamente satisfatório para 15 itens, com total de 0,79, obtendo assim, a reformulação e refinamento do conteúdo do instrumento. Na segunda fase de Delphi, entre julho e agosto de 2015, participaram 26 peritos, e utilizou-se o percentual de concordância acima de 75% para as variáveis consideradas pertinentes ao protocolo de cuidados ao paciente séptico em UTI, obtendo nesta fase, o percentual de concordância de 95%. O protocolo foi concluído com 15 itens, sendo respaldado e modificado, baseado em evidência científica, nas diretrizes internacionais e nas sugestões dos peritos. A utilização do protocolo proposto poderá contribuir para a prática clínica do enfermeiro ao paciente séptico na Unidade de Terapia Intensiva.
Resumo:
The scope of this study was to identify socioeconomic contextual and health care factors in primary care associated with maternal near misses and their marker conditions. This is an ecological study that used aggregated data of 63 clusters formed by the municipalities of State of Rio Grande do Norte, Brazil, using the Skater method of area regionalization, as the unit of analysis. The ratio of maternal near misses and their marker conditions were obtained from the Hospital Information System of the Brazilian Unified Health System. In multiple linear regression analysis, there was a significant association between maternal near misses and variables of poverty and poor primary health care. Hypertensive disorders were also associated with poverty and poor primary care and the occurrence of hemorrhaging was associated with infant mortality. It was observed that the occurrence of maternal near misses is linked to unfavorable socioeconomic conditions and poor quality health care that are a reflection of public policies that accentuate health inequalities.
Resumo:
The scope of this study was to identify socioeconomic contextual and health care factors in primary care associated with maternal near misses and their marker conditions. This is an ecological study that used aggregated data of 63 clusters formed by the municipalities of State of Rio Grande do Norte, Brazil, using the Skater method of area regionalization, as the unit of analysis. The ratio of maternal near misses and their marker conditions were obtained from the Hospital Information System of the Brazilian Unified Health System. In multiple linear regression analysis, there was a significant association between maternal near misses and variables of poverty and poor primary health care. Hypertensive disorders were also associated with poverty and poor primary care and the occurrence of hemorrhaging was associated with infant mortality. It was observed that the occurrence of maternal near misses is linked to unfavorable socioeconomic conditions and poor quality health care that are a reflection of public policies that accentuate health inequalities.
Resumo:
Low birth weight (LBW) is a risk factor for neonatal and infant morbidity and mortality. In Brazil the highest percentages of low birth weight occur in regions of higher socio-economic status. The scope of this article is to ascertain the spatial distribution of low birth weight rates and the correlation with social and service indicators. The scale is ecological taking all the Brazilian states as units of analysis. The spatial analysis technique is the methodology used together with data from SINASC, IPEA and IBGE for 2009. Higher rates of low birth weight are found in the south/southeastern states (Global Moran: 0.267, p = 0.02). Clusters of the high-high type in the Southeast and of the low-low variety in states in the Amazon region are detected. The spatial inequality of low birth weight reflects the socio-economic conditions of the states. More developed regions have higher rates of low birth weight, therefore, the presence of the service and its use decrease infant mortality and increase LBW.
Resumo:
The present study carried out in the context of the Baseline Studies of the PROESF was aimed at evaluating the impact of the Family Health Program (PSF) on indicators for child health in cities with more than 100,000 inhabitants in the Brazilian Northeast. Four cities were investigated. In each one, twenty censual sectors were selected randomly from areas covered by the PSF and compared with twenty sectors selected from areas not covered by the PSF on the basis of socioeconomic criteria. In most cases, no significant differences were found between the areas covered and not covered by the PSF. The only difference found was a significantly lower rate of hospital admissions due to diarrhea but this was on account of the Program of Community Health Agents. The PSF exerted no additional effect on the reduction of this indicator. It was also observed that the way by which the program is implemented in each city interferes directly in the results. Thus, there is no basis for considering the PSF per se ineffective or not differing from other programs with regard to its health care patterns. An evaluation of the PSF would necessarily have to include an analysis of the way the program is implemented and conducted in each case, besides considering its general socioeconomical and political characteristics.
Resumo:
INTRODUCTION: Humanized and quality prenatal and post-partum care is critical to maternal and newborn health, as well as oral health care. Currently, the National Oral Health Policy is aiming at expanding dental care for pregnant women. Thus, the promotion of oral health and attention to prenatal care policies should be integrated; however, there is still limited participation of pregnant women. Thus, it is necessary to verify the knowledge of pregnant women related to oral health, seeking to estimate the quality of dental care provided during prenatal care, being essential for the Family Health strategy to organize personnel, plan costs and to ensure the quality standard of care. OBJECTIVE: To develop and validate a research instrument on the knowledge of pregnant women about their oral health and of their baby. METHOD: This is a construction and validation study with 93 pregnant women in Family Health Units and specialized private clinics in Obstetrics, in the city of Natal / RN. It was authorized by the Onofre Lopes University Hospital Ethics Committee of the Universidade Federal do Rio Grande do Norte (UFRN) under the registration number 421.163/13. The construction of the instrument followed steps so that it was valid, reliable and sensitive: creation and reduction of the items (drafting of the instrument), content validity and testing of the instrument, and hypotheses validation. Once constructed, the instrument was evaluated by experts who suggested modifications. There was consultation with the target population about the new version of the created instrument, which had the instrument validation verified by internal consistency through intra and inter-calibration and test-retest. Next, the hypotheses were validated. A database was built in the Statistical Package for Social Sciences (SPSS), version 22.0. After creating the hypotheses, an association was found for validating the criteria between each of the specific issues for each established criteria, considering a 5% significance level. Data analysis was carried out by describing the absolute and relative frequencies of the variables pertaining to issues relating to their pregnancy knowledge about their oral health and their baby. The Kappa coefficient was used for the calibration process (Inter and Intra-examiner calibration) and Cronbach's alpha coefficient was used to analyze instrument reproducibility (test-retest). In addition, the chi-square test was used to cross the dependent variable with the (dichotomized) independent variables. RESULTS: The intra and inter agreement analysis presented a Kappa coefficient between 0.400 and 1.000. Internal consistency through the analysis showed that 90% of the instrument's questions showed great reliability in the answers (Cronbach α ˃ 0.7). In the investigation of the relationship between the dependent variable (knowledge about oral health) and the independent variables (trimester of pregnancy, education, income and multiparous), it was found that none of these independent variables were significantly associated. All hypotheses had their Ho confirmed. CONCLUSION: The constructed instrument was validated, considering that it showed to be sensitive with good reliability and good accuracy, and therefore can be used to assess pregnant women’s knowledge about their oral health and the oral health of their baby.
Resumo:
INTRODUCTION: Humanized and quality prenatal and post-partum care is critical to maternal and newborn health, as well as oral health care. Currently, the National Oral Health Policy is aiming at expanding dental care for pregnant women. Thus, the promotion of oral health and attention to prenatal care policies should be integrated; however, there is still limited participation of pregnant women. Thus, it is necessary to verify the knowledge of pregnant women related to oral health, seeking to estimate the quality of dental care provided during prenatal care, being essential for the Family Health strategy to organize personnel, plan costs and to ensure the quality standard of care. OBJECTIVE: To develop and validate a research instrument on the knowledge of pregnant women about their oral health and of their baby. METHOD: This is a construction and validation study with 93 pregnant women in Family Health Units and specialized private clinics in Obstetrics, in the city of Natal / RN. It was authorized by the Onofre Lopes University Hospital Ethics Committee of the Universidade Federal do Rio Grande do Norte (UFRN) under the registration number 421.163/13. The construction of the instrument followed steps so that it was valid, reliable and sensitive: creation and reduction of the items (drafting of the instrument), content validity and testing of the instrument, and hypotheses validation. Once constructed, the instrument was evaluated by experts who suggested modifications. There was consultation with the target population about the new version of the created instrument, which had the instrument validation verified by internal consistency through intra and inter-calibration and test-retest. Next, the hypotheses were validated. A database was built in the Statistical Package for Social Sciences (SPSS), version 22.0. After creating the hypotheses, an association was found for validating the criteria between each of the specific issues for each established criteria, considering a 5% significance level. Data analysis was carried out by describing the absolute and relative frequencies of the variables pertaining to issues relating to their pregnancy knowledge about their oral health and their baby. The Kappa coefficient was used for the calibration process (Inter and Intra-examiner calibration) and Cronbach's alpha coefficient was used to analyze instrument reproducibility (test-retest). In addition, the chi-square test was used to cross the dependent variable with the (dichotomized) independent variables. RESULTS: The intra and inter agreement analysis presented a Kappa coefficient between 0.400 and 1.000. Internal consistency through the analysis showed that 90% of the instrument's questions showed great reliability in the answers (Cronbach α ˃ 0.7). In the investigation of the relationship between the dependent variable (knowledge about oral health) and the independent variables (trimester of pregnancy, education, income and multiparous), it was found that none of these independent variables were significantly associated. All hypotheses had their Ho confirmed. CONCLUSION: The constructed instrument was validated, considering that it showed to be sensitive with good reliability and good accuracy, and therefore can be used to assess pregnant women’s knowledge about their oral health and the oral health of their baby.
Resumo:
Over the past decades, starting mainly in the 1960s, the number of elderly has grown in the country and an aging population is considered a remarkable global phenomenon. Given the speed of this process, this growth has produced different implications for the structure of the social, economic and cultural societies and, as such, constitutes new challenges for public policy, and particularly for the Brazilian social assistance policy. Considering the significant increase aging population in Natal and the challenges of social welfare policy, this research aims to identify and analyze the demands and challenges of Social Assistance Policy in the city of Natal / RN, in particular the access of the elderly to social protection basic in the Reference Centers of Social Assistance. This research uses a critical dialectical method, and the methodological procedures that guided the study: the bibliographical research, documentary and field as well as systematic observation. Some initial questions were important to guide this work: What are the demands that come to CRAS the elderly population? What are the answers to these demands by the Basic Social Protection? How this CRAS has implemented social protection responses to these demands as rights guarantee the elderly population? The services offered by CRAS meets user needs? To get the results of this research, bibliographic sources were used, documentary and observation for four (4) CRAS of different district areas of the city of Natal. The results of this research show that basic social protection is quite fragile, leaving part of the population at risk and social vulnerability still without attention due to several factors, including the reduced technical team and the impossibility of service to all neighborhoods referenced by CRAS in the respective zones, and 50% of elderly assisted arising from spontaneous demands.
Resumo:
Over the past decades, starting mainly in the 1960s, the number of elderly has grown in the country and an aging population is considered a remarkable global phenomenon. Given the speed of this process, this growth has produced different implications for the structure of the social, economic and cultural societies and, as such, constitutes new challenges for public policy, and particularly for the Brazilian social assistance policy. Considering the significant increase aging population in Natal and the challenges of social welfare policy, this research aims to identify and analyze the demands and challenges of Social Assistance Policy in the city of Natal / RN, in particular the access of the elderly to social protection basic in the Reference Centers of Social Assistance. This research uses a critical dialectical method, and the methodological procedures that guided the study: the bibliographical research, documentary and field as well as systematic observation. Some initial questions were important to guide this work: What are the demands that come to CRAS the elderly population? What are the answers to these demands by the Basic Social Protection? How this CRAS has implemented social protection responses to these demands as rights guarantee the elderly population? The services offered by CRAS meets user needs? To get the results of this research, bibliographic sources were used, documentary and observation for four (4) CRAS of different district areas of the city of Natal. The results of this research show that basic social protection is quite fragile, leaving part of the population at risk and social vulnerability still without attention due to several factors, including the reduced technical team and the impossibility of service to all neighborhoods referenced by CRAS in the respective zones, and 50% of elderly assisted arising from spontaneous demands.
Resumo:
In view of the climate of instability and deep social inequalities, it has been evident in the Brazilian reality, a new way to punish systematic already developed and consolidated in other countries, in which, among other things, the criminality is anticipated only by danger that the individual sports. It appears, therefore, that the theory developed by Günter Jakobs, nominated Criminal Law of the Enemy, became subtly inserted in the Brazilian reality as well as in international relations signed. In this sense, the Brazilian State, in order to carry out the international legal cooperation in the criminal field, signed a mutual assistance agreement with the government of the United States of America. Forward the conclusion of Mutual legal Assistance Treaty (MLAT), the signatory countries voiced a desire to cooperate in order to facilitate the implementation of tasks of the authorities responsible for law enforcement in both countries, comprising research, investigation, prosecution and prevention of crime, said internalized adjustment in the Brazilian legal system by means of Decree No. 3810 of 02 May 2001. Alongside these considerations, the present study aims to analyze the Criminal law of the Enemy today, seeking to find evidence of that theory in the MLAT, international legal cooperation instrument signed between the government of the Federative Republic of Brazil and the government of the United States of America. Moreover, it has the objective to describe its effects on the Brazilian jurisdiction, especially as concerns the relativity and the suppression of human rights. Once done the introit, analysis will be carried out in the first chapter, on the definition and main features of the theory of Criminal Enemy of the law, it is imperative to approach the humanistic aspect that preceded the theory as well as the dealings given to some controversial issues surrounding it, such as the anticipation of the enemy's punishment and the disproportionality of the penalties imposed. In the second chapter will present the conceptual assumptions, historical evolution and the positives aspects, as well as the barriers and the pursuit of effectiveness of international legal cooperation. In the chapter, bedroom effective analysis of specific modality of cooperation will be held, the Mutual legal Assistance Treaty - MLAT in criminal matters, signed between the Federative Republic of Brazil and the United States of America, in which the general aspects will be addressed and the MLAT reflections on the Brazilian jurisdiction, which includes analysis about the relativity or suppression of human rights, future trends and creating stricter laws, followed by the presentation of the seized conclusion on the subject, in which, among other approaches, will be voiced understanding about the unconstitutionality certain service requests that, from these, there is the bad use of the agreed instrument.
Resumo:
Este trabalho realizado, inicialmente, com base na análise de alguns documentos referentes à legislação educacional brasileira vigente tem por objetivo desenvolver uma investigação acerca da aplicabilidade da Assistência Estudantil dentro do Instituto Federal de Educação, Ciência e Tecnologia de São Paulo (IFSP). A partir da questão do Direito à Educação de todo cidadão, que está garantido em nossa Constituição Federal, o governo elaborou, no ano de 2010, o Programa Nacional de Assistência Estudantil (PNAES). Respaldados nesse Programa, o IFSP criou, em 2011, o Programa de Assistência Estudantil (PAE), dando validade e continuidade às ações desenvolvidas nos Campi para minimizar a evasão e o fracasso escolar, com vistas a garantir a permanência dos educandos no referido Instituto. Embora o PAE tenha sido implementado em todos os Campi do IFSP, no decorrer do presente trabalho analisamos e estudamos, exclusivamente, o Campus Cubatão, localizado na região da Baixada Santista devido a, dentre outros fatores, ter sido a primeira unidade descentralizada dos Institutos Federais do país. Assim, neste estudo, temos como objetivo analisar a estrutura de funcionamento do IFSP com o intuito específico de investigar o Campus de Cubatão, verificar as questões de Vulnerabilidade Social encontradas na destacada instituição, averiguar as ações do PAE que nascem do PNAES, observar a aplicabilidade desse programa com base no princípio da Gratuidade Ativa e do Direito à Educação de todo cidadão. Para tanto, utilizamos, fundamentalmente, além da legislação já mencionada, o princípio da Gratuidade Ativa de Melchior (2011) e o conceito de Vulnerabilidade Social proposto por Alves (1994) e por Abramovay (2002).